**Abstract**

People with Type 2 diabetes mellitus (T2DM) have a 2–3 times higher cardiovascular risk (CVR) than people without diabetes. Atherosclerotic cardiovascular disease (ASCVD) is the major cause of morbidity and mortality in T2DM. Over 30% of those with T2DM have CVD (cardiovascular disease), and over half die from it, mainly from coronary heart disease. The presence of T2DM reduces life expectancy by 10–14 years. The European Society of Cardiology stratifies the CVR into *moderate* (young patients, with a short duration of diabetes, no risk factors), *high* (duration of diabetes >10 years, no target organ damage, plus any additional risk factor) and *very high* (patients with established CVD, target organ injury three CVD risk factors: age, hypertension, dyslipidemia, obesity, or Type 1 diabetes mellitus (T1DM) over 20 years duration). The American Association of Clinical Endocrinologists (AACE) considers that diabetes per se involves high risk. Heart failure (HF) is the second most common complication after obstructive peripheral arterial disease. T2DM associates a 75% higher risk of CV mortality or hospitalization for HF. A multifactorial approach is required to reduce CV morbidity and mortality.

**Keywords:** cardiovascular risk, cardiovascular disease, type 2 diabetes mellitus
